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27-56-5
Section 27-56-5 Third-party payment. (a) No insurance policy, plan, or contract providing for
third-party payment or prepayment of health or medical expenses that provides coverage for
eye care services shall be issued or renewed after August 1, 2001, unless such insurance policy,
plan, or contract does the following: (1) Provides a covered person direct access to any eye
care provider participating in, or otherwise eligible to provide services under, the policy,
plan, or contract for all eye care services covered under the policy, plan, or contract, without
any referral or preapproval requirement, including, but not limited to, the following services,
if covered: a. Medical treatment of glaucoma. b. Postoperative eye care. (2) Ensures that
any list of medical or health care providers participating in, or otherwise eligible to provide
services under, the policy, plan, or contract includes eye care providers to the same extent
that such list includes other medical or health care...
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22-5A-2
Section 22-5A-2 Definitions. For the purposes of this chapter, the following words shall have
the meanings ascribed to them by this section: (1) ADMINISTRATOR. Any person charged with
the general administration or supervision of a health care, domiciliary or residential facility
without regard to whether such person has an ownership interest in such facility or to whether
such person's functions and duties are shared with one or more other persons. (2) COMMUNITY
OMBUDSMAN. A person selected by an area agency on aging who is then trained and certified
as such by the commission pursuant to Section 22-5A-4. (3) DEPARTMENT. Department of Senior
Services. (4) HEALTH CARE FACILITY. Any skilled nursing facility, intermediate care facility,
domiciliary, boarding home facility or hospital now or hereafter subject to regulation or
licensure by the Bureau of Licensure and Certification of the State Department of Health or
a county department of health which provides any generally accepted facet...
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27-21A-1
Section 27-21A-1 Definitions. As used in this chapter, the following terms shall have the following
meanings, respectively: (1) AGENT. A person who is appointed or employed by a health maintenance
organization and who engages in solicitation of membership in such organization. This definition
does not include a person enrolling members on behalf of an employer, union, or other organization.
(2) BASIC HEALTH CARE SERVICES. Emergency care, inpatient hospital and physician care, and
outpatient medical services. (3) COMMISSIONER. The Commissioner of Insurance. (4) ENROLLEE.
An individual who is enrolled in a health maintenance organization. (5) EVIDENCE OF COVERAGE.
Any certificate, agreement, or contract issued to an enrollee setting out the coverage to
which he is entitled. (6) HEALTH CARE SERVICES. Any services included in the furnishing to
any individual of medical or dental care, or hospitalization or incident to the furnishing
of such care or hospitalization, as well as the...
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35-11-372
Section 35-11-372 Release or satisfaction. (a) During the period of time allowed by Section
35-11-371 for perfecting the lien, including that period of time during which the hospital
is awaiting payment or denial by the patient's health care payor, and also after the lien
provided for by this division has been perfected by any lienholder entitled thereto, no release
or satisfaction of any action, claim, counterclaim, demand, judgment, settlement, or settlement
agreement, or of any of them, shall be valid or effectual as against the lien unless the lienholder
shall join therein or execute a release of the lien. (b) Any acceptance of a release or satisfaction
of any action, claim, counterclaim, demand, or judgment and any settlement of any of the foregoing
in the absence of a release or satisfaction of the lien referred to in this division shall
prima facie constitute an impairment of the lien, and the lienholder shall be entitled to
a civil action for damages on account of the...
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22-21-260
Section 22-21-260 Definitions. As used in this article, the following words and terms, and
the plurals thereof, shall have the meanings ascribed to them in this section, unless otherwise
required by their respective context: (1) ACQUISITION. Obtaining the legal equitable title
to a freehold or leasehold estate or otherwise obtaining the substantial benefit of such titles
or estates, whether by purchase, lease, loan or suffrage, gift, devise, legacy, settlement
of a trust or means whatever, and shall include any act of acquisition. The term "acquisition"
shall not mean or include any conveyance, or creation of any lien or security interest by
mortgage, deed of trust, security agreement, or similar financing instrument, nor shall it
mean or include any transfer of title or rights as a result of the foreclosure, or conveyance
or transfer in lieu of the foreclosure, of any such mortgage, deed of trust, security agreement,
or similar financing instrument, nor shall it mean or include any...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-21-260.htm - 11K - Match Info - Similar pages
22-21-7
Section 22-21-7 Itemized statement of services rendered to be furnished patient upon request;
provisions of statement; itemization of services and expenses; action by Attorney General;
payment of claims by insurance companies. (a) For the purposes of this section, the term "hospital"
shall mean any hospital in which human patients are given medical care. It shall include all
emergency rooms or outpatient facilities connected thereto. (b) Within 10 days following discharge
or release from confinement in a hospital or nursing home, or within 10 days after the earliest
date at which the expense from the confinement or service may be determined, which in the
case of long-term confinement may be the monthly charge, the hospital or nursing home providing
the service shall submit to the patient, or to his survivor or legal guardian as may be appropriate,
upon written request, an itemized statement detailing in language comprehensible to an ordinary
layman the specific nature of charges or...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-21-7.htm - 3K - Match Info - Similar pages
26-23C-2
Section 26-23C-2 Legislative findings. (a) The Legislature of the State of Alabama finds all
of the following: (1) Under the Patient Protection and Affordable Care Act, P.L. 111-148,
federal tax dollars, via affordability credits, subsidies provided to individuals between
150-400 percent of the federal poverty level, are routed to exchange participating health
insurance plans, including plans that provide coverage for abortions. (2) Federal funding
of insurance plans that provide abortions is an unprecedented change in federal abortion funding
policy. The Hyde Amendment, as passed each year in the Labor Health and Human Services Appropriations
bill, and the Federal Employee Health Benefits Program, FEHBP, prohibit federal funds from
subsidizing health insurance plans that provide abortions. Under this new law, however, exchange
participating health insurance plans that provide abortions can receive federal funds. (3)
The provision of federal funding for health insurance plans that...
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27-19A-12
Section 27-19A-12 Dental services - Coverages; fees; exceptions. (a) As used in this section,
the following terms shall have the following meanings: (1) COVERED PERSON. Any individual,
family, or family member on whose behalf third-party payment or prepayment of health or medical
expenses is provided under an insurance policy, plan, or contract providing for third-party
payment or prepayment of health care or medical expenses. (2) COVERED SERVICES. Dental care
services for which a reimbursement is available under an enrollee's plan contract, or for
which a reimbursement would be available but for the application of contractual limitations
such as deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums,
frequency limitations, alternative benefit payments, or any other limitation. (3) DENTAL CARE
PROVIDER. A licensed dentist. (4) DENTAL PLAN. Includes any policy of insurance which is issued
by a health care service contractor which provides for coverage of...
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27-19A-3
Section 27-19A-3 Prohibited provisions. No health insurance policy or employee benefit plan
which is delivered, renewed, issued for delivery, or otherwise contracted for in this state
shall: (1) Prevent any person who is a party to or beneficiary of any such health insurance
policy or employee benefit plan from selecting the dentist of his choice to furnish the dental
care services offered by said policy or plan or interfere with said selection provided the
dentist is licensed to furnish such dental care services in this state; (2) Deny any dentist
the right to participate as a contracting provider for such policy or plan provided the dentist
is licensed to furnish the dental care services offered by said policy or plan; (3) Authorize
any person to regulate, interfere, or intervene in any manner in the diagnosis or treatment
rendered by a dentist to his patient for the purpose of preventing, alleviating, curing, or
healing dental illness or injury provided said dentist practices within...
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27-48-1
Section 27-48-1 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) HEALTH BENEFIT PLAN. A health insurance policy that covers hospital, medical,
or surgical expenses, health maintenance organizations, preferred provider organizations,
medical service organizations, physician-hospital organizations, or any other person, firm,
corporation, joint venture, or other similar business entity that pays for, purchases, or
furnishes health care services to patients, insureds, or beneficiaries in this state. For
the purpose of this chapter, a health benefit plan located or domiciled outside of the State
of Alabama is deemed to be subject to the provisions of this chapter if it receives, processes,
adjudicates, pays, or denies claims for health care services submitted by or on behalf of
the State of Alabama or who receive health care services in the State of Alabama. The term
includes, but is not limited to, entities created pursuant to Article 6 of...
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